Region III Powerhouse Chapter Visit Form
Greetings all,

Want the REB to come visit your chapter? Is there an event you would like us to attend? Use this form to request the REB appearance at one of your events (AWOE, chapter meeting, banquet, etc.) This form will be the only way to request for a chapter visit, emails will not be accepted.

Please allow two week for a response from the Membership Chair, Naia Butler Craig at r3membership@nsbe.org

Name *
First and Last Name
Your answer
Chapter Name *
Your answer
Position *
If not on the CEB, please input "member"
Your answer
Phone Number *
Your answer
Email *
Your answer
Dates for Visit (Please Include Times!) *
Please list the top 3 dates in which you would prefer a chapter visit(Please do not list past dates).
Your answer
Did your chapter recieve a chapter visit within the last year? *
What is the main reason for the chapter visit?
Your answer
Is there a certain REB member you would like to attend this event? *
Your answer
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This form was created inside of National Society of Black Engineers.